Attention-Deficit/Hyperactivity Disorder (ADHD) and Cerebral Palsy

Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition that causes difficulties with impulse control and attention. It commonly begins between ages 3 and 6, and may continue into adulthood (1). Roughly 5% of children have ADHD (2).

Individuals with ADHD can experience a broad range of symptoms, including (but not limited to) (1):

• Interrupting others during conversation
• Difficulty paying attention (inattention)
• Overactivity (hyperactivity)
• Constant body movements
• Impulsivity
• Making careless mistakes in everyday tasks
• Having difficulty listening in conversations
• Struggling with organization or deadlines
• Avoiding tasks that require long-term focus or attention
• Getting easily distracted
• Losing things needed for everyday tasks

According to the National Institute of Mental Health (NIMH), ADHD is associated with such risk factors as (1):

• Brain injury and cerebral palsy
• Low birth weight
• Exposure to environmental toxins at a young age
• Maternal alcohol use, cigarette smoking, or drug use during pregnancy
• Genetic factors

There is no cure for ADHD, but many treatments have been found to improve symptoms. For children under age 6, behavior therapy is the most common treatment option. Children over 6 can receive medication in conjunction with behavior therapy. The following medications are approved to treat ADHD in people over 6 years of age (3, 4, 5):

• Stimulants, including Adderall, Concerta, Ritalin, and others: Stimulants target dopamine in the brain, which plays a role in movement, emotion, and motivation. An estimated 70-80% of children with ADHD experience fewer symptoms with stimulant medications.
• Non-stimulants: Non-stimulant ADHD medications target norepinephrine, which plays a role in attention. Non-stimulant ADHD medications take much longer than stimulant ADHD medications to bring about results, but are useful in children whose symptoms remain after, or who experience side effects from, stimulants.

*All medications have side effects and/or risks. Always talk to your child’s doctor about how each of these medications may affect your child. 

Children with cerebral palsy (CP) may have a broad range of cognitive and developmental impairments which can affect attention and learning. There are often comorbidities, or associated and simultaneous conditions with cerebral palsy, including such neurodevelopmental disorders (NDDs) as Autism Spectrum Disorder (ASD), Intellectual and Developmental Disabilities (IDDs), Speech and Language issues, and Attention-Deficit/Hyperactivity Disorder (ADHD) (2).

An estimated 19-40% of children with CP experience ADHD (6). This occurs because individuals with CP are generally at an increased risk of the following symptoms (6):

• Impaired inhibitory control
• Attention issues (including visual attention)
• Difficulties with organization and planning
• Slower processing speeds (PS)

ADHD and other comorbidities of CP often interact with and relate intricately to one another. Further studies are warranted to learn the best way to treat the many different complexities of cerebral palsy and the best way to help children experience ADHD and CP together (2).

1. Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics. (2016). Retrieved May 22, 2020, from https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml
2. Craig, F., Savino, R., & Trabacca, A. (2018, November 2). A systematic review of comorbidity between cerebral palsy, autism spectrum disorders and Attention Deficit Hyperactivity Disorder. Retrieved May 29, 2020, from https://www.sciencedirect.com/science/article/pii/S1090379818301533
3. Treatment of ADHD. (2019, October 8). Retrieved May 23, 2020, from https://www.cdc.gov/adhd/treatment/
4. Silver, L., Silver, L., & Dodson, W. (2019, August 30). ADHD Medications for Adults and Children: ADD Stimulants, Nonstimulants & More. Retrieved May 23, 2020, from https://www.additudemag.com/adhd-medication-for-adults-and-children/
5. Team, U. (2019, October 16). Types of ADHD Medications. Retrieved May 28, 2020, from https://www.understood.org/en/learning-thinking-differences/treatments-approaches/medications/types-of-adhd-medications
6. Shank, L. K., Kaufman, J., Leffard, S., & Warschausky, S. (2010). Inspection time and attention-deficit/hyperactivity disorder symptoms in children with cerebral palsy. Rehabilitation psychology, 55(2), 188–193. https://doi.org/10.1037/a0019601